Department of Critical Care, Cardiac Anesthesia and Intensive Care Unit, AORN Dei Colli, Monaldi Hospital, Naples, Italy.
Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli," Naples, Italy.
J Cardiothorac Vasc Anesth. 2021 Mar;35(3):711-729. doi: 10.1053/j.jvca.2020.03.054. Epub 2020 Apr 20.
Despite improvements in surgical techniques and perioperative care, cardiac surgery still is burdened by relatively high mortality and frequent major postoperative complications, including myocardial dysfunction, pulmonary complications, neurologic injury, and acute kidney injury. Although the surgeon's skills and volume and patient- and procedure-related risk factors play a major role in the success of cardiac surgery, there is growing evidence that also optimizing perioperative care may improve outcomes significantly. The present review focuses on the aspects of perioperative care that are strictly related to the anesthesia regimen, with special reference to volatile anesthetics and neuraxial anesthesia, whose effect on outcome in adult cardiac surgery has been investigated extensively.
尽管外科技术和围手术期护理有所改善，但心脏手术仍然存在相对较高的死亡率和频繁的主要术后并发症，包括心肌功能障碍、肺部并发症、神经损伤和急性肾损伤。尽管外科医生的技能、手术量以及患者和手术相关的风险因素在心脏手术的成功中起着主要作用，但越来越多的证据表明，优化围手术期护理也可以显著改善预后。本综述重点关注与麻醉方案严格相关的围手术期护理方面，特别提到了挥发性麻醉剂和椎管内麻醉，它们对成人心脏手术的结果的影响已经得到了广泛的研究。
